Klaus Linde's research while affiliated with Technische Universität München and other places

Publications (380)

Preprint
Objectives To estimate the treatment incidence of Post-Covid Syndrome in the context of office-based care in Bavaria, Germany, and to establish whether related diagnoses occur more frequently than in patients with no known history of COVID-19. Design Retrospective analysis of routinely collected claims data. Setting Office-based care in Bavaria,...
Article
Asthma education programs (AEPs) for patients are known to be important to provide skills to effectively manage the disease. We developed an electronic AEP (eAEP) and assessed the extent to which patients with asthma in primary care are capable to use the eAEP and whether asthma knowledge improved after eAEP. A single-arm pilot study was performed...
Article
Zusammenfassung Ziel der Studie Im Rahmen des in Bayern festgestellten Katastrophenfalls in der frühen Corona-Phase 2020 wurden sog. Versorgungsärzt*innen (VÄ) für die ambulante Versorgung etabliert. Ziel der vorliegenden Befragungen war eine Bewertung dieser neu eingeführten, jedoch zeitlich begrenzten Position. Methodik Im November 2020 wurde ein...
Article
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Background This study aimed to investigate the knowledge, attitudes, behaviors, and COVID-19 vaccine hesitancy of people with migratory backgrounds among Turkish- and German-speaking patients in Munich. Methods Primary outcomes were the intention to get vaccinated for COVID-19 and COVID-19 knowledge levels (25 true/false items). Other variables in...
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Background After the ‘first wave’ in spring 2020, opinions regarding the threat and measures against COVID-19 seemed to vary among German general practitioners (GPs). Objectives To systematically investigate opinions and to identify subgroups of GPs sharing similar views. Methods A questionnaire was sent to all 210 practices accredited for underg...
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The study aimed to evaluate the diagnostic accuracy of contact history and clinical symptoms and to develop decision rules for ruling-in and ruling-out SARS-CoV-2 infection in family practice. We performed a prospective diagnostic study. Consecutive inclusion of patients coming for COVID-PCR testing to 19 general practices. Contact history and self...
Article
Hintergrund: Um die hausärztliche Koordination zu stärken, wurde 2004 die Praxisgebühr eingeführt. Diese wurde, begründet mit einer mangelnden Wirksamkeit gegenüber einem zu hohen bürokratischen Aufwand, 2012 abgeschafft. Die vorliegende Arbeit ist eine Zusammenfassung der relevantesten Ergebnisse zweier international publizierter Artikel, die die...
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Background Risk factors of severe COVID-19 have mainly been investigated in the hospital setting. We investigated pre-defined risk factors for testing positive for SARS-CoV-2 infection and cardiovascular or pulmonary complications in the outpatient setting. Methods The present cohort study makes use of ambulatory claims data of statutory health in...
Article
ZUSAMMENFASSUNG Hintergrund Die vorliegende Studie untersucht die Beeinflussung der Tätigkeit von Hausärzt*innen und Orthopäd*innen durch die empfundene Regressgefahr und das Ausmaß eigener Regresserfahrungen. Methoden Einer bundesweiten Zufallsstichprobe von 1000 Hausärzt*innen und 1000 Orthopäd*innen wurde ein 4-seitiger Fragebogen mit Fragen zu...
Article
Background: This study investigated the feasibility to conduct an educational webinar for improving COVID-19-related knowledge, attitudes, and behaviors in Munich. Methods: A before-after experiment was conducted in Turkish-speaking family physician offices. Turkish-speaking participants (n=245) of a cross-sectional study evaluating COVID-19 knowle...
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To strengthen the coordinating function of general practitioners (GPs) in the German healthcare system, a copayment of €10 was introduced in 2004. Due to a perceived lack of efficacy and a high administrative burden, it was abolished in 2012. The present cohort study investigates characteristics and differences of GP-coordinated and uncoordinated p...
Preprint
Full-text available
Background This study aimed to investigate the knowledge, attitudes, behaviors, and vaccine hesitancy of people with migratory backgrounds among Turkish- and German-speaking patients in Munich regarding the COVID-19 pandemic. Methods Primary outcomes were the intention to get vaccinated for COVID-19 and COVID-19 knowledge levels (25 true/false item...
Preprint
Full-text available
Background This study aimed to investigate the knowledge, attitudes, behaviors, and vaccine hesitancy of people with migratory backgrounds among Turkish- and German-speaking patients in Munich regarding the COVID-19 pandemic. Methods Primary outcomes were the intention to get vaccinated for COVID-19 and COVID-19 knowledge levels (25 true/false item...
Article
Context: Migraine is a common neurologic disorder in children and adolescents. However, a comparison of multiple nonpharmacological treatments is lacking. Objective: To examine whether nonpharmacological treatments are more effective than waiting list and whether there are differences between interventions regarding efficacy. Data sources: Sys...
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Background Acupuncture is used to treat patients with diabetic peripheral neuropathy; however, the evidence is unclear. We present the design and methodology of the ACUDPN (ACUpuncture in Diabetic Peripheral Neuropathy) trial, which investigates the effectiveness of acupuncture for the treatment of diabetic peripheral neuropathy (DPN) symptoms. The...
Preprint
Full-text available
Background: Acupuncture is used to treat patients with diabetic peripheral neuropathy; however, the evidence is unclear. We present the design and methodology of the ACUDPN (ACUpuncture in Diabetic Peripheral Neuropathy) trial, which investigates the effectiveness of acupuncture for the treatment of diabetic peripheral neuropathy (DPN) symptoms. Th...
Article
Objectives The degree to which the effects of acupuncture treatment vary between acupuncturists is unknown. We used a large individual patient dataset of trials of acupuncture for chronic pain to assess practitioner heterogeneity. Methods Individual patient data linked to identifiable acupuncturists were drawn from a dataset of 39 high-quality tri...
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Objectives: In 2012, Germany abolished copayment for consultations in ambulatory care. This study investigated the effect of the abolition on general practitioner (GP)-centred coordination of care. We assessed how the proportion of patients with coordinated specialist care changed over time when copayment to all specialist services were removed. F...
Article
Background: Qualitative and quantitative surveys show that many German general practitioners (GPs) use complementary and alternative medicine (CAM) in their daily work. However, participants in such studies were mostly experienced GPs. Objective: The aim of this study was to investigate systematically how young GPs view CAM and to what extent an...
Article
Background In a recent individual patient data meta-analysis, acupuncture was found to be superior to sham and non-sham controls in patients with chronic pain. It has been suggested that a subgroup of patients has an exceptional response to acupuncture. We hypothesized the presence of exceptional acupuncture responders would lead to a different dis...
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Background: Many German general practitioners (GPs) use complementary and alternative medicine (CAM) in their daily work although most CAM procedures are controversial from an academic point of view. Objective: We aimed to investigate how GPs justify their use of CAM. Methods: We performed semi-structured, individual face-to-face interviews wi...
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Background: Although the role of general practice has been strengthened in recent years, undergraduate teaching at medical schools and the clinical phase of specialist training remain dominated by specialized care of seriously ill people in hospitals. It is to be assumed that young doctors' views on medical care are strongly shaped by this clinica...
Article
Importance Migraine is one of the most common neurologic disorders in children and adolescents. However, a quantitative comparison of multiple preventive pharmacologic treatments in the pediatric population is lacking. Objective To examine whether prophylactic pharmacologic treatments are more effective than placebo and whether there are differenc...
Article
Background: Asthma education (AE) is associated with reduced hospitalization and disability. We compared the effectiveness of an electronic AE program (eAEP) with a conventional face-to-face AE program (presence-based AEP; pAEP) for asthma knowledge (AK) with regard to self-management. Methods: A randomized controlled pilot study was conducted i...
Article
There is a growing interest in non-pharmacological pain treatment options such as cupping. This meta-analysis aimed to assess the effectiveness and safety of cupping in chronic pain. PubMed, Cochrane Library, and Scopus were searched through November 2018 for randomized controlled trials on effects of cupping on pain intensity and disability in pat...
Article
Background The COVID-19 pandemic poses major challenges to family medicine practices. In a cross-sectional survey we investigated the caseload and the perceived challenges in Southern Bavarian primary care practices during the first phase of the pandemic. Methods A four-page questionnaire was sent to all 210 practices accredited for under-graduate...
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Background: Although the impact of asthma education on important outcomes (e.g. emergency visits) has been well established, only an estimated quarter of asthma patients in Germany have received patient education yet. The aim of the study was to identify patient factors that could increase participation in asthma education programs. Methods: Thi...
Article
Background: To investigate HL (health literacy) and eHealth literacy (eHL) among two groups of asthma outpatients, those with prior asthma education and those without. In addition, we aimed to compare two shortened versions of a HL measure instrument. Methods: A cross-sectional survey was conducted with a sample of adult asthma patients (n = 129)....
Article
Introduction: The aim of this pilot study was to evaluate the effectiveness of a complex educational intervention to improve the diagnostic competencies of general practitioners (GPs) regarding the detection of depression, anxiety and somatization. Methods: Cluster-randomized controlled pilot study with six practices each in the intervention group...
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Background One of the known weaknesses of spirometry is its dependence on patients’ cooperation, which can only partially be alleviated by educational efforts. Therefore, procedures less dependent on cooperation might be of value in clinical practice. We investigated the diagnostic accuracy of ultrasound-based capnovolumetry for the identification...
Article
OBJECTIVES: To optimally select chronic pain patients for different treatments, as it is of interest to identify patient characteristics that might moderate treatment effect. Our aim was to evaluate the impact of possible moderators on the effect of acupuncture treatment using a large data set. METHODS: We used data from an individual patient data...
Article
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Background In routine practice, general practitioners (GPs) see many patients for whom treatment might not be necessary, or evidence-based treatments are not available, yet often a treatment is prescribed. We denote such situations as therapeutically indeterminate. We aimed to investigate 1) whether therapeutically indeterminate situations play a r...
Article
Objectives: To optimally select chronic pain patients for different treatments, as it is of interest to identify patient characteristics that might moderate treatment effect. Our aim was to evaluate the impact of possible moderators on the effect of acupuncture treatment using a large data set. Methods: We used data from an individual patient da...
Preprint
BACKGROUND Asthma education programs (AEP) in combination with keeping an asthma diary and usage of an asthma action plan to foster self-management is associated with reduced hospitalization, disability and mortality. However, only few patients are participating in presence educational programs which might be due to time constraints, organizational...
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Allergic rhinitis and asthma: German version of control test verified A newly-translated German version of a two-factor asthma test shows promise as a reliable tool for assessing disease control. Asthma frequently co-exists with allergic rhinitis (AR), a condition in which allergies cause irritation and inflammation of the nasal passages. To verify...
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Objective: To assess the evidence for the safety and efficacy of invasive procedures for reducing chronic pain and improving function and health-related quality of life compared with sham (placebo) procedures. Design: Systematic review with meta-analysis. Methods: Studies were identified by searching multiple electronic databases, examining re...
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Background Traumatic events like critical illness and intensive care are threats to life and bodily integrity and pose a risk factor for posttraumatic stress disorder (PTSD). PTSD affects the quality of life and morbidity and may increase health-care costs. Limited access to specialist care results in PTSD patients being treated in primary care set...
Data
Reasons. Reasons for prescribing placebo interventions. (PDF)
Data
Numeric data on frequency of use. Proportion (95%CI) of physicians using any type of placebo, pure placebos and non-specific therapies. (PDF)
Data
Search strategies. Search strategies for PubMed, Medline, Scopus and Google Scholar. (PDF)
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Background In a systematic review and meta-analysis we summarize the available evidence on how frequently general practitioners/family physicians (GPs) use pure placebos (e.g., placebo pills) and non-specific therapies (sometimes referred to as impure placebos; e.g., antibiotics for common cold). Methods We searched Medline, PubMed and SCOPUS up t...
Data
Specific interventions used as placebos. Proportions (95%CI) of physicians having used specific interventions as placebos. (PDF)
Data
Raw data for meta-analysis. Raw data for meta-analysis. (XLSX)
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Results of quality assessment. Results of quality assessment of individual studies. (PDF)
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Definitions. Definitions and examples of placebo interventions given to survey participants in included studies. (PDF)
Article
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Background: Even in practices with a comprehensive appointment system a minority of patients walks in without prior notice, sometimes causing problems for practice service quality. We aimed to explore differences between patients consulting primary care practices with and without appointment. Methods: Consecutive patients visiting five primary c...
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Background Selective reporting of outcomes in clinical trials is a serious problem. We aimed to investigate the influence of the peer review process within biomedical journals on reporting of primary outcome(s) and statistical analyses within reports of randomised trials. Methods Each month, PubMed (May 2014 to April 2015) was searched to identify...
Chapter
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Treatment-related expectations are important predictors for placebo effects in various medical conditions. They are formed by verbal and nonverbal cues during the administration of treatments, such as verbal suggestions, conscious and unconscious associations with previous treatments, characteristics of patients and health-care providers as well as...
Conference Paper
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Background: High expectations about acupuncture might contribute to larger treatment effects (Prady et al., 2015). However, problems in the assessment are well known: 1) floor or ceiling effects lower variance; 2) expectation measures include general beliefs about complementary medicine; 3) construct validity of expectation measures remains unclear...
Article
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The “Asthma Control Questionnaire” (ACQ) is a very common questionnaire for assessing asthma control. This study compares different ACQ versions in a self-monitoring program over a 12-week period combining them with patients' self-measurements of peak expiratory flow (PEF) and forced expiratory volume in one second (FEV1). The objective was to test...
Article
Perspective: Acupuncture is effective for the treatment of chronic musculosketal, headache and osteoarthritis pain. Treatment effects of acupuncture persist over time and cannot be explained solely in terms of placebo effects. Referral for a course of acupuncture treatment is a reasonable option for a patient with chronic pain.
Article
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Background International studies have shown a contribution of psychiatric comorbidity to high utilization rates in out-of-hour primary care (OOHC). Up to now, the impact of psychiatric comorbidity in German OOHC remains unclear. Therefore, we aimed to investigate reasons for encounter (RFE), possible psychiatric comorbidity, utilization rates, and...
Article
Aim: The Somatic Symptom Disorder-B Criteria Scale (SSD-12) assesses the psychological features of DSM-5 somatic symptom disorder. The purpose of the current study was to investigate the psychometric characteristics and validity of the 12-item instrument to demonstrate its suitability in primary care. Method: The study was designed as a cross-se...
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Objectives A considerable proportion of regional variation in healthcare use and health expenditures is to date still unexplained. The aim was to investigate regional differences in the gatekeeping role of general practitioners and to identify relevant explanatory variables at patient and district level in Bavaria, Germany. Design Retrospective ro...